胎儿疼痛:对证据的系统的多学科审查
Susan J Lee1, Henry J Peter Ralston, Eleanor A Drey
1School of Medicine, Department of Anatomy, University of California, San Francisco, CA 94143-0648, USA.
JAMA
|August 25, 2005
概括
胎儿在第三个三个月之前不太可能感知疼痛,因为它需要尚未发展的有意识意识. 目前胎儿手术中的麻醉技术在堕胎中没有被证明是安全或有效的.
科学领域:
- 医学研究 医学研究
- 产科 产科 产科 产科 产科
- 麻醉学 麻醉学
背景情况:
- 拟议的立法规定,在20周以上的堕胎期间,必须向妇女提供关于胎儿疼痛的信息,并提供胎儿麻醉.
- 这需要检查胎儿疼痛能力以及直接胎儿麻醉的安全性/有效性.
研究的目的:
- 评估关于胎儿疼痛感知的科学证据.
- 评估安全有效的直接胎儿麻醉或疼痛缓解技术的可用性和适用性.
主要方法:
- 在PubMed的系统文献搜索中,搜索关于胎儿疼痛,麻醉和止痛的英语文章.
- 包括研究的重点是人类胎儿 (<30周妊娠年龄) 或胎儿疼痛/nociception.
- 没有日期限制的搜索,截至2005年6月6日.
主要成果:
- 疼痛感知需要有意识的意识;胎儿的反射和压力反应不证实疼痛.
- 对于疼痛意识所必需的功能性脑皮层连接,在23-30周之间发展.
- 胎儿手术中的麻醉除了减轻疼痛之外还有其他目的,而且这些技术并不直接适用于堕胎.
结论:
- 有限的证据表明,胎儿在第三个三个月之前不太可能感知疼痛.
- 几乎没有证据证明直接胎儿麻醉/止痛药对堕胎的有效性或安全性.
- 在胎儿手术中目前的麻醉实践不能转移到堕胎程序中.
相关概念视频
Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Imaging Studies for Cardiovascular System V: CT
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
Imaging Studies II: Ultrasonography
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
Imaging Studies III: Computed Tomography
DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...


